Reimagining Cardiovascular Service Lines to Drive Growth and Value

Cardiovascular service lines are in the midst of a major transformation, reshaping how physicians and health systems deliver care. Sites of service are shifting, patients present with greater complexity, and prevention is taking on a more prominent role across the continuum of care. In this episode of Value-Based Care Insights, host Daniel Marino is joined by longtime colleague and nationally recognized leader Dr. Nihar Desai, Associate Professor of Medicine and Vice Chief of Cardiovascular Medicine at Yale School of Medicine. Dr. Desai brings a unique perspective at the intersection of research, operations, and value-based transformation, as he and Daniel take a deep dive into the evolving cardiovascular service line. They discuss what these changes mean for clinical outcomes, financial performance, and the patient experience.

Strengthening service line performance requires a strong foundation in primary care, which remains central to delivering effective value-based care. Yet, the landscape of primary care delivery is marked by significant challenges including workforce shortages, provider burnout, administrative burdens, and increasing barriers to patient access. In this episode of Value-Based Care Insights, host Daniel J. Marino kicks off a new series exploring specialty service lines by starting with the primary care service line. He is joined by Dr. Sarita Soares, Program Director for the Yale Primary Care Internal Medicine Residency Program, and Dr. Brad Richards, Executive Director of the Yale Primary Care Internal Medicine Residency Program and Associate Professor of Medicine at the Yale School of Medicine. Together, they discuss the shifting dynamics of primary care, the growing integration of behavioral health, the role of technology in improving access, and what healthcare leaders can do to better support providers and patients in this changing environment.

In this episode of Value-Based Care Insights, host Daniel J. Marino reflects on his experience at the Lead from Identity Summit, a transformative leadership conference hosted by Dr. Doug McKinley in Silverton, Colorado. Unlike traditional leadership events focused on strategies and communication tactics, this summit challenged participants to explore how their personal identity shapes their leadership style and response to challenges. Daniel, a summit participant, is joined by two fellow attendees—Michelle Williams, Senior Nursing Executive and Chief Nursing Officer, and Lucy Zielinski, Managing Partner at Lumina Health Partners and a member of the summit’s planning team—to discuss key takeaways from the event. Together, they discuss how leading from identity fosters authenticity, resilience, and meaningful connections across healthcare teams—and how self-awareness and purpose-driven leadership can transform the way we lead and serve others. Want to learn more about leading from identity? Check out Dr. McKinley's podcast episode Leading from Identity with Jamie Winship

Across the U.S., hospitals and surgical centers are facing a growing provider shortage—particularly among anesthesiologists. At the same time, demand for surgical and procedural services continues to rise, especially in ambulatory surgery centers (ASCs). This imbalance has forced many healthcare organizations to rethink their anesthesia coverage models. In this episode of Value-Based Care Insights, host Daniel J. Marino sits down with Dr. Thomas Pallaria, Assistant Professor and Director of the Nurse Anesthesiology Program at Rutgers School of Nursing, to discuss the evolving role of Certified Registered Nurse Anesthetists (CRNAs). Together, they explore the growing reliance on CRNAs to meet demand, the benefits and challenges of integrating them into care models, and the implications for hospitals, anesthesiologists, and patient outcomes.

As CMS continues to expand value-based care programs, one stands out for its focus on supporting some of our most vulnerable patients—and their caregivers. The GUIDE model (Guiding an Improved Dementia Experience) is designed to improve care for individuals with dementia and Alzheimer’s, while providing essential resources and support for the family members and caregivers who support them. In this episode of Value-Based Care Insights, host Daniel J. Marino is joined by Seth Hyman, Co-Founder and Partner at JVS Health. Together, they explore the goals of the GUIDE model, why CMS is prioritizing dementia care, and how health systems can prepare to implement and benefit from this transformative initiative.

The newly signed One Big Beautiful Bill Act is reshaping the healthcare landscape, with ripple effects for providers, payers, and patients. From Medicaid coverage shifts and rural hospital funding challenges to stricter ACA rules, expanded value-based care, and mandatory risk models, the implications are broad and far-reaching. In this episode of Value-Based Care Insights, host Daniel J. Marino speaks with Ben Sparks, President of Bryan Health Connect, a clinically integrated network, to examine four critical areas leaders must prepare for: projected Medicaid losses, financial pressures on hospitals, new insurance access rules, and the wider fiscal and political fallout across states. Drawing on Bryan Health Connect’s experience, Ben shares practical takeaways to help leaders adapt to the new law.

In this episode of Value-Based Care Insights, host Daniel Marino is joined by Christina Kuta, a healthcare attorney specializing in regulatory and transactional healthcare law. Together, they explore the growing shift toward concierge medicine and address common misperceptions surrounding full and hybrid concierge models. They discuss key legal and contractual considerations—ranging from commercial insurance implications to the Medicare opt-out process and membership agreements—that providers must understand before transitioning to concierge practices. Tune in to gain insights into how physicians can successfully navigate regulatory requirements, protect patients, and build sustainable concierge practices.

In this episode of Value-Based Care Insights, host Daniel Marino explores the potential impact of new federal legislation, including One Big Beautiful Bill Act of 2025, which is set to reshape healthcare delivery and payment models. He is joined by Natalie Davis, a nationally recognized health policy leader who has spent nearly two decades shaping and implementing initiatives to improve access to affordable, high-quality care for all. In 2018, Natalie co-founded United States of Care, an organization dedicated to advancing health equity and ensuring care is accessible regardless of health status, social needs, or income. She also played a key role in launching Town Hall Ventures and The Medicaid Transformation Project. Together, they examine the implications of the legislation for hospitals across the country, highlighting both the opportunities to advance value-based care and the challenges of adapting to new funding and operational requirements. Tune in to gain insights into how hospitals can proactively prepare for change, navigate evolving financial pressures, and sustain access and quality of care particularly in resource-limited settings. Strategies are explored to help organizations achieve success while maintaining strong community impact.

In this episode of Value-Based Care Insights, host Daniel Marino tackles one of healthcare’s most persistent challenges: physician burnout. Joining him are two experts who bring both clinical and research perspectives to the conversation. First, Dr. Stephen Hippler, a retired Chief Clinical Officer at OSF HealthCare, oversaw more than 1,500 physicians and advanced practice providers and has led initiatives to support provider well-being and a thriving work culture. Second, Dr. Laurence Weinzimmer, an endowed research professor at Bradley University, is a nationally recognized healthcare researcher and advisor to Fortune 100 companies.  Together, they share insights from their latest study on “physician fortitude” examining the deeper, human roots of burnout, the organizational and cultural factors at play, and the strategies needed to drive meaningful change. Listeners will gain an understanding of why burnout persists, and what leaders can do to better support clinicians, build resilience, and improve workforce well-being over the long term. 

In this episode of Value-Based Care Insights, host Daniel Marino explores the evolving role of operating room (OR) nurse leaders within the perioperative service line. As perioperative services become an increasingly important strategic and financial focus for hospitals and health systems, the demand is growing for leaders who can combine clinical expertise with business and operational acumen. Joining the conversation is Cheryl Barratt, a seasoned healthcare consultant with over 30 years of experience in surgical services operations, system integration, and performance improvement. Cheryl discusses how perioperative nurse leaders, while strong clinically, frequently lack the training needed to manage the broader responsibilities of these roles. She shares practical insights into how organizations can support their development with leadership, financial, and strategic competencies that enable them to lead more effectively and drive long-term performance.